Saturday, February 17, 2024

90 Of Oncologists Wouldn T Take Chemo

Concerns About Chemo And Your Natural Defenses

Nurse (Chemo Infusion), Career Video from drkit.org

A growing population of adults are choosing to refuse chemo is based on the way in which it works. Chemotherapy does not kill your immune system as claimed, but it can harm it temporarily. The potential for this side effect is well known and the oncologist will prepare for it and monitor your immune system closely throughout treatment. This is a large part of the reason why, if you do choose to elect chemotherapy, your blood will be closely monitored through tests during your treatment. This concern is not unfounded but it is debatable, as the effects on your immune system end shortly after the round of chemo does.

Advances In Cancer Care That Have Improved The Chemotherapy Experience

Cancer clinical trials, such as those we offer here at CTCA®, have resulted in an increasing number of treatment options and chemotherapy drugs. More options means your oncologist may have more choices if a treatment isnt working for you or if youre experiencing difficult treatment-related side effects. A quick look at the National Cancer Institutes list of drugs approved to treat breast cancer provides a good example of how treatment options have increased.

Researchers have also worked hard to reduce the toxicity of some drugs. Modifications include changing the dosage amounts, the intervals of administration and even how theyre administered. For example, researchers found that giving Velcade® to patients newly diagnosed with multiple myeloma may in most patients when its given by subcutaneous injection instead of by infusion.

Medications to prevent nausea and vomiting in those patients who experience it have also improved over the years. Some anti-nausea medications may be given at the same time as a patients chemotherapy infusion.

Chemotherapy drugs are sometimes used in combination with other innovative treatment options, such as targeted therapy or immunotherapy. In patients whose cancer exhibits certain genomic mutations, immunotherapy may keep their cancer in check on a long-term basisalmost as if it were a chronic illness like type 2 diabetes or heart disease.

Can Receiving Less Chemotherapy Result Ultimately In Better Outcomes

Chemotherapy can shrink cancer and slow its growth, which is why it has been used to treat breast cancer in conjunction with surgery for so many years. But the side effects can be difficult.

In the short term, these side effects can include such problems as nausea, fatigue, and hair loss, which can sometimes last far beyond treatment. We know that, after a course of chemotherapy, a number of women, up to several years out, don’t regain their full vitality, Dr. Winer says.

But even more concerning are the long-term effects, which can include rare, but difficult, complications such as heart problems, neuropathy, and leukemia, which can ultimatelyand indirectlyaffect outcomes.

These potentially debilitating side effects are why personalizing chemotherapy treatment has become so important. If a patient can do just as well with fewer medical treatments, it’s almost always a better thing, says Dr. Winer. Less chemotherapy can mean fewer side effects, less anxiety, improved quality of life, and possibly even a longer life, he adds.

Also, when side effects are truly debilitating, treatment delivery may be impaired, Dr. Lustberg says. If we can enhance how patients are feeling during treatment, they may actually tolerate treatment better, stay on it longer, not need dose reductions or modifications, and have better disease outcomes. It’s all interrelated.

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Process Of Decision Making

Most recommendations in oncology are not based solely on high-level evidence . While guideline adherence can rightfully be viewed as positive, one should be aware that only 6% of the recommendations found in NCCN guidelines are based on high-level evidence . Even in the clinical routine of academic oncology centers, most treatments are not based on high-level evidence . In these settings, lower levels of evidence are used, for example, the results of phase II trials or observational studies. Where none of this evidence is available, recommendations are based on expert opinion.

Using structured approaches to decision making involving multiple criteria can provide insight into objective parameters of decision making. An example for such an approach is the objective consensus methodology . By analyzing and comparing decision trees based on the same rules and terminology, information on medical decision making among medical experts can be obtained. Based on information from multiple sources in the decision tree format, treatment recommendations can be assessed for every possible parameter combination . For various cancer forms and settings, even among highly specialized medical centers or experts, the use of decision criteria varies considerably .

Fig. 2.

A Reasonable Look At Oncology:

Its Chemo Day  Geoff Fox: My Permanent Record

Notice this doctors license plate does not say HEALNGDOC,ONCODOC, or KANSRDOC.

This picture provides much insight into the belief system of this doctor and the conventional medical model. Oncologists have been taught in their pharmaceutical-sponsored medical schools that the only thing that will cure cancer are drugs and other complicated, invasive medical treatments. In fact, if they believed and did otherwise, they would lose their medical license! Its that serious.

The annual cost of cancer care in the United States projected to be $173 billion by 2020. The majority of cancer patients already well exceed $100,000 for the cost of their cancer treatment. Pharmaceutical cancer treatment makes oncologists A LOT of money.

Would you be surprised if I told you that in many cases 60-70% of an oncologists practice is coming from the sale of chemotherapy and other cancer drugs? This was really eye opening for me. In a way, oncologists are placed in a situation where the sale of chemotherapy and other cancer drugs is their livelihood. Most of the skillset they worked to achieve in their career would be rendered useless if they didnt have chemotherapy to sell as treatment to their patients.

So could it be they are just part of a medical and financial model they find themselves stuck in?

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What Are Common Side Effects Of Chemo

Most people worry about whether theyll have side effects from chemo, and, if so, what theyll be like. Here are some of the more common side effects caused by chemotherapy:

  • Nausea and vomiting
  • Mouth, tongue, and throat problems such as sores and pain with swallowing
  • Peripheral neuropathy or other nerve problems, such as numbness, tingling, and pain
  • Skin and nail changes such as dry skin and color change
  • Urine and bladder changes and kidney problems
  • Chemo brain, which can affect concentration and focus
  • Changes in libido and sexual function
  • Fertility problems

Learn more about these and other problems in Managing Cancer-related Side Effects.

The Strategic Lies Of Oncologists

Is it ethical to break cost-controlling rules for a patients benefit?

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Well have to invent symptoms, the doctor said. Since this physician was a paragon of integrity, the patient gasped. With what words could she thank the doctor for such a breach of insurance rules?

Many have fulminated against oncologists who lie to patients about their prognoses, but sometimes cancer doctors lie for or with patients to improve our chances of survival.

Heres the back story in this case. The patient, a woman in her early 50s, was given a diagnosis of endometrial cancer. After three infusions of chemo, she was supposed to start radiation, but imaging for it detected tumor growth. In other words, her disease was so malevolent that malignancy progressed during treatment. Yet physicians successfully altered the regimen, which she weathered. While some women with gynecologic cancer can use the CA125 blood test as a marker for recurrence, for others it does not work at all they need scans. This patient is in that category, so she and her oncologist agreed to rely on a CT scan every nine months.

A shell game, she tells me, suspecting that her doctor must hate the lie as much as she does: How humiliating for this consummate professional.

Read Also: What To Expect After Chemo For Lymphoma

How Is Chemotherapy Used In Cancer Treatment Today

How chemotherapy is used in treatment depends on the type and stage of the cancer and how aggressive it is. Some cancers, such as an indolent lymphoma or prostate cancer, may not need immediate treatment, but chemotherapy may eventually be recommended if the cancer progresses. Other cancers require immediate treatment.

Chemotherapy may be used alone as the primary treatment for a cancer, or it may be used in combination with other treatments, such as surgery, radiation therapy, targeted therapy or immunotherapy.

An oncologist may recommend chemotherapy before and/or after another treatment. For example, in a patient with breast cancer, chemotherapy may be used before surgery, to try to shrink the tumor. The same patient may benefit from chemotherapy after surgery to try to destroy remaining cancer cells.

Chemotherapy may also be used to relieve symptoms caused by advanced cancer, which improves a patients quality of life. Some of these patients may be able to take occasional breaks from treatment.

The types of cancers where chemotherapy is very commonly used as primary treatment include:

Chemotherapy drugs are often delivered by infusiona process that may take several hours. Oral drugs, however, are now an option for many patients, which allows some patients the convenience of chemotherapy treatment at home. Other delivery options may include injections, topical creams and drugs that are injected directly in the abdominal cavity or the central nervous system.

Been Asked If I Want Chemo For Bc

Texas oncology nurse continued to treat patients even after her own cancer diagnosis

I had my first apt with oncology today and I was under the impression I was going to get the details of my treatment plan and when my chemo would start . The oncologist has asked me to place myself on the scale – 1) let’s through everything at it to give me as much peace of mind as possible… 2) let’s have a look at the risks and benefits before we make a decision here!

For my bc type, size and age bracket, chemo would only give me a 9% reduced risk of no recurrence. So that’s a 90-91% chance of not working. That’s poor odds for such a tough treatment.

Have anyone else on here been given the option? The oncologist said I wouldn’t be mad to not have chemo but that it’s a decision we must reach together and he’s unable to make it for me.

@Julmess @Marlyn What type of bc do you both have?

Mine is ductal and ER positive which I believe is the most common type of bc. It’s been classed as stage 2 – I had 2 tumours and some additional tissue removed that was shown to be cancerous, as well as 13 lymph nodes removed . I had been told by my surgeon that I would have to have chemo.

He explained that some people want to just have everything they can to give themselves the peace of mind that they’ve done everything to get rid of it. But the reality is that the surgery has got rid of it. Chemo is about risk management. Some people benefit more from that than others. However the chemo isn’t a guarantee that you won’t get cancer again.

Read Also: How To Keep Your Hair During Chemo

Does Chemo Age Your Face

So, it is not surprising that many people feel that they age dramatically during chemotherapy. During chemotherapy, the epidermis loses its ability to hold on to moisture, which leads to fine lines in the skin’s surface. In the dermis, the collagen and elastin break down, which weakens the skin’s support structure.

Questions To Ask Your Doctor About Chemotherapy

Patients are sometimes reluctant to ask questions, but I tell my patients that any question is an important question when it comes to their cancer care. Oncologists deal with cancer every day, but it’s all new to the patient. Getting your questions answered will help you make informed decisions about your care.

Think about your questions before your appointment. Write them down and bring them with you. I also recommend bringing a family member or friend to take notes during the appointment because its easy to get overwhelmed by information.

Here are some questions to consider asking your doctor about chemotherapy:

  • What drug or drugs are you recommending?
  • Whats the goal of this treatment?
  • How long will I be on it?
  • How do I receive it?
  • How often do I have to come in? Can someone come in with me?
  • If Im taking this drug at home, where do I store it? How often do I take it? What if I forget to take it?
  • What are the potential side effects? Are you going to give me anything ahead of time to deal with them?
  • Am I likely to have long-term side effects from this drug?
  • Who do I call if Im at home and I have a question?
  • What kind of support is there to help me through this treatment?
  • Is there any support for my caregivers?

If you think of more questions after your appointment, call back and ask them.

If you start chemotherapy and your experience is different from what you expected, talk to your care team. They may be able to make changes that help you.

Also Check: Sores In Mouth From Chemo

Treating Advanced Prostate Cancer

If the cancer has reached an advanced stage, it’s no longer possible to cure it. But it may be possible to slow its progression, prolong your life and relieve symptoms.

Treatment options include:

  • hormone treatment

If the cancer has spread to your bones, medicines called bisphosphonates may be used. Bisphosphonates help reduce bone pain and bone loss.

Most Expensive Cancer Drugs

Non

Four of the five most expensive cancer drugs on the U.S. market are types of immunotherapies, according to Memorial Sloan Kettering Cancer Centers Drug Pricing Lab.

Several of these drugs cost nearly as much or more per month than the average American makes in a year, which is $46,800, according to the latest data available from the U.S. Bureau of Labor Statistics.

Read Also: How To Prevent Childhood Cancer

Which Types Of Breast Cancers Do Well With Less Chemotherapy

Research in the last two decades has shown that two types of breast cancer respond well to less-intensive chemotherapyor none at allin some cases:

  • HR-positive: This is the largest breast cancer subtype, accounting for as many as 75% of all cases. The majority of women diagnosed with this subtype of breast cancer have no lymph node cancer at the time of diagnosis. Both for these women and many with positive lymph nodes, hormonal therapy is the most important treatment, and chemotherapy may not be needed, Dr. Winer says.
  • HER2-positive. This aggressive breast cancer makes up 15 to 20% of breast cancer cases. Once a deadly disease, even in its early stages, it is now curable in more than 90% of cases, Dr. Winer explains. In early HER2-positive cancers, weve found that very limited courses of chemotherapy can be just as effective as treatment that is more extreme, he says.

People Living In Poverty

Cancer death rates are approximately 20% higher among residents of the poorest U.S. counties compared to the most affluent counties. The largest gaps are seen in preventable cancers, including lung, cervical, colorectal and liver cancers.

States with the Highest Poverty Rates

States in the Southern, Central and Western regions have the highest poverty rates, according to 2017 statistics from the U.S. Census Bureau. Eight of the 10 states with the highest poverty rates also rank in the top 10 for cancer death rate, according to the CDC.

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How Do We Know That Less Or No Chemotherapy Really Is Enough For Her2

Early in the 2000s, trastuzumab , a monoclonal antibody, was introduced to treat women with relatively advanced cases of HER2-positive breast cancer, and it was successful, Dr. Winer explains.

Suddenly, women with relatively advanced forms of breast cancerwith lymph node involvementwere doing exceptionally well, he says. So, then we asked ourselves: If you have a very small HER2-positive breast cancer and no lymph node involvement, do you still need such complex chemotherapy treatments? In a study published in the New England Journal of Medicine almost a decade ago, we demonstrated that one could give a limited course of chemotherapy along with trastuzumab and achieve outstanding results.

Good Prostate Cancer Care

Most Cancer Doctors are Sociopaths!

Your MDT will be able to recommend what they feel are the best treatment options, but ultimately the decision is yours.

You should be able to talk with a named specialist nurse about treatment options and possible side effects to help you make a decision.

You should also be told about any clinical trials you may be eligible for.

If you have side effects from treatment, you should be referred to specialist services to help stop or ease these side effects.

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Claims That Chemo Is Poison

A moderate percentage of no-chemo proponents used the chemo-is-mustard-gas rationale for refusal. Although this point is partially based in fact, science has come leaps and bounds since those first experiments using mustard gas, or mustard nitrogen, to treat lymphoma back in the WWII era. Giving furtheralbeit overblowncredence to that argument is the fact that to this day there is still some use of mustard nitrogen in cancer treatment. A drug called Mustargen is still used occasionally to treat other cancers, but not colorectal cancer.

Do You Have To Be Certified To Administer Chemotherapy

There are no state or federal regulations that require a nurse to be certified in chemotherapy. Oncology nurses are nurses that specialize in treating cancer patients. Some employers may need oncology certification. Other employers may prefer candidates with nursing degrees who want to become oncology nurses.

About Article Author

Amy Terhune

Amy Terhune is a woman with many years of experience in the medical field. She has worked as a nurse for many years, and currently works as an instructor at a nursing school. Amy enjoys teaching new things, and helps people to understand their bodies better.

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